1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32 | with lotion. Staff also stated that they check on all residents every two hours and immediately if a resident uses their call button requesting assistance. Staff stated that incontinence care is provided every two hours and as needed, if a resident uses the call button requesting assistance. Administrator stated that R1 was seen twice a day by home health and that facility staff cared for R1's needs as needed and always followed the doctors orders as well as home health nurse orders. She stated that facility staff are trained in providing adequate care and supervision, as well as the importance of providing assistance with Activities of Daily Living (ADLs) for any resident that requires assistance with ADL's. She stated that staff were providing R1 with shower assistance twice a week and staff had not reported that they had observed any changes with R1's skin. Per medical records review, the home health agency indicated that R1's skin condition did not vary from 06/11/22 - 07/17/22 indicating that their skin was cool, dry, clammy and also stated that the nurse performed a comprehensive nursing assessment of all body systems, blood sugar was checked via fingerstick, diabetic foot exams were performed with no abnormal findings noted. The nurse also noted that they prepared and gave the insulin subcutaneously and skin was intact. On 07/18/22, records indicate that the home health nurse documented that R1's skin was cool, dry, clammy, pallor and wounds were observed. The nurse documented the wound care per physician's orders. The nurse also noted weakness and poor fluid intake at which time the nurse decided to call the physician who ordered that R1 be taken to the hospital. Interviews conducted with 7 out of 7 residents revealed that the facility staff are helpful, check on them often and respond to the call system right away. One resident was bed bound at the time of LPA visit, and they stated that they do not have any concerns, staff check on them every 2 hours or sooner and when they need assistance, they use the signal system, and staff respond quickly. This resident stated that they can shift around without assistance. Residents requiring shower assistance stated that staff give them their showers as scheduled and they do not have any complaints. LPA observed staff tending to residents and observed that residents appeared clean. LPA also tested the signal system in 8 resident rooms and verified that the signal system is working, and staff responded in less than two minutes. Based on statements gathered from interviews conducted with staff, facility residents, LPA observations and record review, there was not enough supportive evidence to concur with the reported allegation.
For allegation, Staff did not adequately manage resident's glucose, it is alleged that R1's A1c level was at 17 when they were hospitalized on 07/18/22. Administrator stated that R1's glucose was checked daily and insulin was administered as well and staff know to call the doctor if R1's glucose is very high. Interview conducted with facility administrator revealed that R1 was provided adequate and timely care at all times.
|